Maintaining oral health throughout gestation is a fundamental part of comprehensive prenatal care. You should inform your dental provider about your pregnancy. This disclosure allows the dental team to adapt their approach, ensuring the safety of both the patient and the developing fetus.
Why Disclosure is Medically Necessary
Disclosure allows the dental provider to adjust the treatment plan to avoid or modify specific interventions that could potentially affect fetal development. For instance, certain antibiotics, such as tetracycline, must be avoided entirely because they interfere with the proper formation and color of fetal teeth and bone. Pain relievers commonly used after dental procedures, like nonsteroidal anti-inflammatory drugs (NSAIDs), are often contraindicated and require a safer alternative.
Knowing about the pregnancy is necessary for assessing the risk associated with diagnostic procedures like dental X-rays. While modern dental radiographs use extremely low doses of radiation and are considered safe with protective lead aprons, imaging should only be performed when absolutely necessary for diagnosis. If a higher-risk procedure is required, the dentist can coordinate directly with the patient’s obstetrician-gynecologist (OB-GYN). This collaborative approach ensures that treatment timing and prescribed medications align with prenatal care recommendations.
Hormonal Impact on Oral Health
The surge in hormones, particularly estrogen and progesterone, directly affects the body’s response to plaque bacteria. These elevated hormones increase blood flow to the gum tissues and exaggerate the inflammatory response. This makes the gums more sensitive and prone to swelling and bleeding, a common condition known as pregnancy gingivitis. It typically manifests between the second and eighth months of gestation.
If this heightened inflammation is not managed with diligent hygiene and professional cleanings, the condition can progress to periodontitis. Periodontitis is a serious infection that damages the bone and tissue supporting the teeth. Untreated periodontal disease has been associated with an increased risk of adverse pregnancy outcomes, including preterm birth and lower infant birth weight.
Morning sickness is another concern due to its effect on tooth structure, especially with frequent vomiting. Vomiting exposes the teeth to highly corrosive gastric acids, which erode the outer layer of enamel over time. This erosion increases the risk of tooth decay and sensitivity. After episodes of vomiting, rinse the mouth with plain water or a fluoride rinse rather than brushing immediately, as brushing softened enamel can cause further abrasion.
Scheduling and Treatment Safety
The safest and most comfortable period for most routine and necessary dental procedures is the second trimester (weeks 13 to 27). By this time, the fetus’s organ systems are fully formed, and the patient is typically past the most severe period of morning sickness. Routine procedures like professional cleanings and examinations are safe to perform at any point during the pregnancy.
For necessary restorative work, such as fillings or root canals, local anesthesia like lidocaine is considered safe when administered in appropriate dosages. Lidocaine is classified as a Category B drug by the Food and Drug Administration, meaning studies have not shown a risk to the fetus. Non-elective treatments should never be postponed, as an active dental infection can introduce bacteria into the bloodstream and cause systemic complications.
The dental team will take precautions to ensure physical comfort, especially in the later stages of pregnancy. During the third trimester, the patient may be positioned slightly on her left side with a pillow while in the dental chair. This adjustment prevents the growing uterus from compressing the vena cava, which can cause dizziness or a drop in blood pressure. Elective or cosmetic dental procedures should be postponed until after the baby is born.